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Thursday, 16 March 2006

Capgras syndrome – in which the patient believes their friends and relatives have been replaced by impersonators – was first described in 1923 by the French psychiatrist J.M.J. Capgras in a paper with J. Reboul-Lachaux.

Now Alireza Nejad and Khatereh Toofani at the Beheshti Hospital in Iran have reported an extremely rare variant of Capgras syndrome in which a 55-year-old woman with epilepsy believes her possessions have all been replaced by substitute objects that don’t belong to her. When she buys something new, she immediately feels that it has been replaced.

However, the authors reported “there was no evidence of dementia, her memory was intact, and her immediate, recent, and remote memories were okay. She was oriented to time, place and person, and had appropriate intelligence”. She also had no history of head injury or migraine, and brain scans revealed no gross abnormality.

The woman developed grandmal epilepsy when she was thirty. Then three months before her psychiatric referral, she had a seizure followed by the sensation that someone was following her. Then it was after her next seizure that she developed the delusional belief that all her things had been swapped. The authors can’t explain her delusion but believe it may be related to right-hemisphere frontal and temporal abnormalities. “No remarkable point was present in the patient’s history, and there was no psychosocial stress prior to her psychotic episode” they said.
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In another paper, a patient thought hospital staff were hired actors in a stage production. See Silva, J.A. et al. (1990). An unusual case of Capgras syndrome: the psychiatric ward as a stage. Psychiatric Journal of the University of Ottawa, 15, 44-46.